2024 Volume 41 Issue 1 Pages 33-
The present study retrospectively reviewed the electronic medical records of 28 patients with Mpox who visited the Department of Dermatology at Tokyo Medical University Hospital between January 1, 2023 and June 9, 2023. All the patients were men who have sex with men, and most were in their 20’s to 40’s (mean age: 38.9 years). The primary symptom was a rash consisting of erythema, erythematous papules, bullae/pustules, ulcers, and crusts in the genital area in 15 cases, trunk and extremities in 22 cases, face in ten cases, and palms and soles in five cases (including duplicate cases). Other clinical symptoms included fever in 25 cases, lymphadenopathy in eight cases, pharyngitis in three cases, headache in two cases, malaise in one case, and analgia in four cases (including duplicate cases). Twenty-four of 27 patients (including previously infected patients) were HIV-positive, 21 of 25 patients (including previously infected patients) were syphilis-positive, and 15 of 17 patients were positive for pre-existing hepatitis B. Twelve patients were positive for the HIV-syphilis-hepatitis B antigen triad. In the entire cohort, sexual activity was the transmission route in 26 patients; 27 patients were followed up without treatment only; and one patient was admitted for the tecovirimat clinical trial and recovered. The present study found a particularly high incidence of HIV among patients in the dermatology department as well as cases of various, other, sexually transmitted disease. Because the skin symptoms of Mpox vary, diagnosis without prior information, such as HIV positivity, is often difficult. If Mpox is suspected in a patient with no such information, it is important to ascertain if there is a history of homosexual intercourse or sexually transmitted disease; in addition, the relevant health department should be consulted, and care should be taken not to puncture or remove any vesicles without wearing protective clothing.
